Chapter 2 Classification of Clubfoot

Assessing a clubfoot deformity, especially in the neonatal period, requires an exhaustive checklist where inspection, palpation, and reducibility are the key points. However, clinical assessment should not be limited to a simple orthopedic evaluation of the foot as about 10% of clubfeet are nonidiopathic. A severity scale is very useful to differentiate feet accurately, an initial reference is necessary to assess progress of treatment, and standardization of terms allows better exchanges of information. Within the spectrum of all possible clubfoot conditions, there are different degrees of involvement, from the stiffest to the softest foot (benign, moderate, severe, and very severe). Classification is, therefore, essential to both score clubfoot at birth and assess the impact of treatment. However, all classification systems are necessarily arbitrary. This chapter provides not only an overview of clubfoot classifications systems but also how classifications systems could potentially drive change. Further classification systems are needed to further guide post casting care and truly predict children in need of other modalities and/or treatment to minimize relapse.